Repair of Traumatic Aortic Rupture

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Abstract
ACUTE RUPTURE of the thoracic aorta following blunt trauma is a life-threatening injury that often requires urgent operative intervention. Despite improvements in resuscitation, transport, and critical care, emergency repair of aortic disruption in a trauma patient with multiple injuries is still associated with a high mortality rate. Moreover, paraplegia remains a devastating complication of traumatic aortic rupture (TAR).1-4 Although different surgical techniques have been described for management of this lethal injury, the debate continues as to the optimal method of repair (primary anastomosis vs interposition graft) and whether distal aortic perfusion modifies patients' outcomes.5-10 This report reviews our experience treating patients with TAR in a tertiary care teaching hospital, which is also a level I regional trauma center. We present the various surgical strategies and methods of repair used during a 25-year period, and an evaluation of the clinical outcomes of such operative treatments.